Active NPI
Ray G. Poggi, M.D.
- Psychiatry Physician
- Berkeley, CA
National Provider Identifier
1700904794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- C34764
- Practice address
- 2041 Bancroft Way
Suite 307
Berkeley, CA 94704-1405 - Phone
- (510) 644-3434
- Fax
- (510) 649-1133
- NPI assigned
- Mar 27, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | C34764 | CA | Primary |
Addresses
Primary practice location
2041 Bancroft Way
Suite 307
Berkeley, CA 94704-1405
Mailing address
2041 Bancroft Way
Suite 307
Berkeley, CA 94704-1405
Phone (510) 644-3434
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective May 8, 2016 through May 8, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34764 | CA | MD | Mental Health Counselor |
| C34764 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700904794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2041 BANCROFT WAY",
"address_2": "SUITE 307",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947041405",
"telephone_number": "510-644-3434",
"fax_number": "510-649-1133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2041 BANCROFT WAY",
"address_2": "SUITE 307",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947041405",
"telephone_number": "510-644-3434",
"fax_number": "510-649-1133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POGGI",
"first_name": "RAY",
"middle_name": "G.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "C34764",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.